December 3, 2016

The 6-Week NCLEX-RN® Study Strategy

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Congratulations, you have successfully finished nursing school. I know, you're already stressed about your upcoming NCLEX-RN® examination. You're almost at the finish line and the only thing standing between you and a flawless victory is this exam. You've made it through nursing foundations and the nursing techniques courses. You've even perfected insulin administration and giving medications through nasogastric tubes. Now it's time to use that expertise toward analyzing and interpreting various nursing-based performance scenarios. This is a 6-week game plan on passing the NCLEX-RN® exam.

  • Time Dedication: 2 to 4 Hours Per Day
  • Activities: Reading & Taking Notes
Before we get into practice questions, I recommend each individual purchase a book (or a credible online resource) that breaks down each body system in great detail. Before we get into infections and disease processes, we need to understand the baseline of the human condition. I'm talking about S1, S2, what these mean, and where they're located. I'm talking about the legit foundations. Even if you're fresh out of nursing school, you need this refresher. Body systems are the starting point and this section will assist you in understanding the typical clinical presentation. When you know what the norms are, finding abnormal clinical manifestations are a breeze. If you know that normal urine output is at least 30 ml/hr and your patient produces only 10 ml/hr, you know something is wrong. That intuition, that critical thinking, all stems from you understanding body systems and how they function.

When I was in nursing school, I purchased a book titled Saunders Comprehensive Review for the NCLEX-RN® Examination. This book broke down each body system in outline format. What I enjoyed most about this book was the body systems evaluation. In the cardiology section, it went over heart sounds, locations, and subsequent expected outcomes. This text disseminated information in a structured manner. It started from basics and went into the intricate dynamics of nursing. I recommend this book, but any book that can accomplish this goal will work. The goal is to purchase or rent a resource that will assist you in understanding each body system in its entirety. You will not know why certain signs and symptoms of hyperkalemia present themselves if you don't understand what the body does with potassium on a cellular level. You can't run before you walk. All the boring stuff has to be understood in order to move onto the gross and cool stuff.

  • Time Dedication: 2 to 4 Hours Per Day
  • Activities: Reading & Taking Notes
We've made it to the second week and now it's time to apply your nursing foundations to abnormal conditions. You know about S1 and S2, but what if you hear S3? What does that mean? What nursing interventions are expected? This is the meat and potatoes of the NCLEX-RN® examination. Many questions revolve around nurses analyzing a situation and determining what the next assessment or action will be. This is nursing in a nutshell. You think you're going to get tested on what S1 and S2 signify? Umm, no. Your state nursing board wants to know that you can safely care for ill individuals. You can't test someone's critical thinking skills by asking questions about healthy people in routine circumstances. The NCLEX-RN® exam isn't about healthy people in optimal settings, who require no medications or interventions. It's about the people who will need you - the sick and the ill.

This segment will take twice as long as foundations because the cardiovascular system is the same for everyone (in most cases). The pipes are the same and their functions are the same. But, heart failure has many classes and presentations, along with different symptoms within diverse age groups. To successfully understand this section, you will need to dedicate a good amount of time toward discerning conditions found in each body system. Yeah, this isn't sexy or entertaining. But again, we must build upon the foundations in order to be ready for the practice questions section. As mentioned earlier, the Saunders Comprehensive Review for the NCLEX-RN® Examination book is a great resource, with an outline format on disease processes too.

  • Time Dedication: 1 to 2 Hours Per Day
  • Activities: 50 to 75 Questions Per Day
You've made it to the promise land! Your hands hurt, you're exhausted from reading, and now it's time to apply what you've learned these past few weeks. Regardless of what route you take, you need find practice questions and a lot of them. Whether it's through programs such as Hurst, Kaplan, or from a book, you need to practice. You must test your knowledge in order to find out if you've successfully grasped the content. It's one thing to take notes and read. It's another to analyze the information and accurately apply it on an exam. You could use the Saunders Comprehensive Review for the NCLEX-RN® Examination book, as it has practice questions at the end of each chapter. But I recommend either purchasing or renting at least 2 to 4 books. I found that each author brings their nonpartisan perspective in the form of practice questions. It's in your best interest to use as many credible resources as you can in this section. Some books I found helpful include:

1. Pearson NCLEX-RN® Practice Questions Exam Cram
2. Prioritization, Delegation & Assignment: Practice Exercises NCLEX® Examination
3. Kaplan Test Prep: NCLEX-RN® Premier 2016 with 2 Practice Tests

  • Time Dedication: Varies
  • Activities: Reading Notes & Re-Taking Tests
If you take an exam and get less than 75%, you did NOT understand the content thoroughly, and you need to revisit steps one and two. This section is about honesty and will require you to be realistic with yourself. You can't expect to get 30% on all your practice exams and then walk into the NCLEX-RN® exam assuming you will ace it because you understand all the aspects of nursing care. Clearly, there is a disconnect somewhere and you need to revisit some parts of your study material. If you invest in yourself, you will be successful. The preparation and the long nights will pay off. Ignoring what you don't know will only cause problems. If you don't understand why you keep getting renal failure questions wrong, you doing more renal failure practice questions won't educate you on the matter. You need to go back to body systems. You shouldn't test yourself on concepts that are unfamiliar to you - it's a waste of time. You need to go back, review your notes, and find the gaps in your education. It's annoying but necessary. Please don't skip this step. This is where the rubber meets the road. You can do all the practice questions you want. Eventually, your memory will kick in and you will start getting better scores. But you haven't really learned anything - you're just going off sheer memory. The goal of practice questions isn't to do the same test 20 times until you get a 100%. The goal is to test your knowledge and find potential gaps.

  • Medications & Pharmacology
This is a tough subject for some and it requires its own mention. When it comes to medications, you will likely be asked about expected outcomes (e.g. lowers blood pressure, relieves headaches), potential side effects (e.g., nausea, abdominal pain), and nursing related implications (e.g., monitor for heart block or dysrhythmias). My advice to you is to first group medications by their drug class (e.g., beta-adrenergic blockers, selective serotonin re-uptake inhibitors). This will enable you to classify drugs with similar names (generic names) and allow for faster identification. After grouping, you can then go into the expected outcomes and associated side effects. Most medications within the same drug class tend to have similar side effects, so grouping them will make this pattern easy to recognize. One company who has the medication game on lock is the organization. They offer tons of information about drugs and pharmacology commonly presented on the NCLEX-RN® exam. Here are some links:

1. FREE The Ultimate Nursing Pharmacology Study Guide
2. FREE 50 Most Commonly Prescribed Medications Cheatsheet

So yeah, that is it. It's time-consuming, I know. But you passing this exam will determine your future employment status and the course of your nursing career. Don't sleep on the importance of preparation. When you walk into an exam cold and unprepared, you usually don't do so well. But every time I've truly dedicated myself to a plan, it never went sideways on me. I went into the exam calm and capable. I hope you can too using this strategy. I wish you the best of luck and I can't wait to work alongside you!

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